Newborn hearing screening: Will children with hearing loss caused by congenital cytomegalovirus infection be missed?

Objective: To predict whether universal newborn auditory screening Mill ide ntify most infants with sensorineural hearing loss (SNHL) caused by congeni tal cytomegalovirus (CMV) infection. Study design: A cohort of 388 children born between 1980 and 1996 at one ho spital and identified during the newborn period as having congenital CMV in fection received repeated hearing evaluations to assess whether hearing los s had occurred. Results: SNHL was detected in 5.2% of all infants at birth. Late-onset SNHL occurred among the children throughout the first 6 years of life. BS the a ge of 72 months, the cumulative incidence of SNHL was 15.4% in the cohort. Children with clinically apparent disease at birth had significantly more S NHL than children without any apparent disease (22.8% vs 4.0% at 3 months a nd 36.4% vs 11.3% at 72 months of age). Conclusions: Universal screening of hearing in neonates will detect less th an half of all SNHL caused by congenital CMV infection. Because most infant s with congenital CMV infection are without symptoms at birth, ;these child ren are unlikely to be recognized as being at risk for SNHL and will not re ceive further hearing evaluations to detect late-onset hearing loss. A comb ined approach of universal screening of neonates for hearing, as well as fo r detection of congenital CMV infection, needs to be considered.